Abstract:
BACKGROUND:A combination of midazolam and opioid is usually used to achieve sedation and analgesia during colonoscopy. Two commonly used opioids are meperidine and fentanyl, but few studies have compared their efficacy. OBJECTIVE:This randomized trial aimed to compare the efficacy and recovery time of 2 sedation regimens consisting of midazolam in combination with either meperidine or fentanyl. DESIGN, SETTING, AND PATIENTS:A total of 300 consecutive, unselected adults attending outpatient colonoscopy at a District General Hospital were enrolled with informed consent and randomized to receive midazolam with meperidine or fentanyl. Data for procedure times, perceived discomfort (according to standard 100-mm visual analog scales [VAS]), and recovery time were collected. Patients and all endoscopy staff directly involved with the procedure were blinded to the regimen used. MAIN OUTCOME MEASUREMENTS:Primary: patients' experience of pain (postrecovery VAS score); secondary: recovery time. RESULTS:A total of 287 patients (150 female, mean [SD] age 54 [17] years) were studied. Recovery time (in minutes) was significantly shorter in patients receiving fentanyl (n = 138) than in those receiving meperidine (n = 149, mean +/- SE: 13.7 +/- 1.8 vs 18.7 +/- 1.7, P = .03), whereas there was no difference in the patients', endoscopists', or nurses' perception of pain during the procedure between the 2 groups. Both groups received a median dose of 3 mg of midazolam (range 2-5 mg). In patients receiving lower doses (2-2.5 and 3-3.5 mg), recovery times were significantly faster with fentanyl (P < .01 and <.05, respectively), whereas at higher doses of midazolam (> or =4 mg) there was no difference between the 2 groups. LIMITATIONS:The use of VAS scores and nurse assessment of recovery time were chosen in this study because, despite their subjectivity, these measures were felt to most closely reflect true clinical practice. CONCLUSIONS:The use of fentanyl in combination with low-dose midazolam results in significantly faster recovery from sedation compared with meperidine, without any apparent loss of analgesic effect.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Hayee B,Dunn J,Loganayagam A,Wong M,Saxena V,Rowbotham D,McNair Adoi
10.1016/j.gie.2008.09.033subject
Has Abstractpub_date
2009-03-01 00:00:00pages
681-7issue
3 Pt 2eissn
0016-5107issn
1097-6779pii
S0016-5107(08)02621-7journal_volume
69pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Endoscopic papillary balloon dilation (EPBD) has a lower risk of hemorrhage than sphincterotomy and is easier to perform in altered/difficult anatomy. However, the sphincter of Oddi (SO) is only stretched but not cut after EPBD. Therefore, the biliary orifice is less opened, and failed stone extraction with ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2010.07.009
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND AND AIMS:Colonoscopy is commonly performed for colorectal cancer screening in the United States. Reports are often generated in a non-standardized format and are not always integrated into electronic health records. Thus, this information is not readily available for streamlining quality management, particip...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.08.038
更新日期:2020-09-03 00:00:00
abstract:BACKGROUND AND AIMS:Fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening is superior to the traditional binary fecal occult blood test. Its quantitative nature allows the investigator to choose a positivity threshold to match cost and endoscope capacity. The optimal threshold is still debated. BowelS...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.08.015
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:EUS-FNA can be used to accurately diagnose and stage GI and pulmonary neoplasms. This study evaluated the performance characteristics of a new compact linear EUS system during EUS-FNA. METHODS:A total of 37 patients enrolled in this prospective pilot study underwent clinically indicated EUS-FNA and/or celia...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)70038-8
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Placement of a pancreatic duct (PD) stent reduces post-ERCP pancreatitis rates in high-risk patients. Patients with suspected sphincter of Oddi dysfunction (SOD) who are found to have normal manometry results (SOM) are also at high risk for this complication. OBJECTIVE:Our purpose was to determine whether P...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.06.022
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Zenker's diverticulum (ZD) is an uncommon disease, which is typically treated surgically. The alternative to surgery is a diverticulotomy, performed endoscopically. Given the rarity of this condition, it is not possible to obtain training. There has been no animal model identified that resembles the disease ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.10.052
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The mechanisms leading to occlusion of plastic biliary stents (PBS) are not known. OBJECTIVE:To evaluate the impact of reducing duodenobiliary reflux on stent patency rate. DESIGN:A newly designed antireflux PBS (AR-PBS) was tested in vitro by using ox bile. A prospective randomized trial in human beings w...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2006.09.011
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Most cases of duodenal carcinoid have conventionally been treated by surgical resection. The aim of our study was to explore the feasibility of endoscopic resection in small duodenal carcinoids. METHODS:The study population consisted of seven patients with small duodenal carcinoids. The diagnosis was confir...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(98)70246-9
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Roux-en-Y gastric bypass (RYGB) is refractory to lifestyle and pharmacotherapy measures, requiring reversal of the patient's bariatric surgery. Reversal can lead to weight regain and recrudescence of their comorbidities. Our aim was to report a multicenter experience on the endoscopic management of ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.02.029
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND AND AIMS:EMR is the primary treatment of large laterally spreading lesions (LSLs) in the colon. Residual or recurrent adenoma (RRA) is a major limitation. We aimed to identify a robust method to stratify the risk of RRA. METHODS:Prospective multicenter data on consecutive LSLs ≥20 mm removed by piecemeal EM...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2016.11.027
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:EMR has been accepted as a treatment modality for selected cases of early gastric cancer (EGC) in Japan. However, long-term outcomes after EMR for EGC have not been fully documented. OBJECTIVES:We reviewed the experiences of EMR for EGC in Korea, with emphasis on the long-term outcome. DESIGN:Multicenter, ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2007.04.013
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND AND AIMS:The greatest known risk factor for duodenal cancer in familial adenomatous polyposis (FAP) is Spigelman stage (SS) IV duodenal polyposis. Endoscopic surveillance is recommended in FAP patients with SS 0 to IV, and prophylactic duodenectomy should be considered in SS IV. Cancer occurs in patients wit...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.07.033
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Endoscopic resection of large colorectal lesions is associated with high complication rates. OBJECTIVE:To evaluate the effect of prophylactic clip closure of polypectomy sites after resection of large (≥2 cm) sessile and flat colorectal lesions. DESIGN:Retrospective study. SETTING:Tertiary referral center...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.10.024
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Direct percutaneous endoscopic jejunostomy (DPEJ) placement succeeds in 72% to 86% of attempts. Failure is most often because of inadequate transillumination or gastroduodenal obstruction. Even in failed cases, patients are exposed to the risks of anesthesia, exploratory percutaneous needle punctures, and th...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.10.035
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:The rate of spontaneous migration of bile duct stones through the duodenal papilla is not well known. Endoscopic retrograde cholangiography (ERC) has been the standard method to diagnose bile duct stones, but accumulating data show there is a good agreement between ERC and endoscopic ultrasonography (EUS). T...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(00)70414-7
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND AND AIMS:EUS-guided gallbladder drainage (EUS-GBD) is a challenging technique for endoscopists that requires a high level of skill. EUS-GBD is challenging because the gallbladder can be easily collapsed. To resolve this issue, we aimed to develop a retrievable puncture anchor traction (RPAT) method for EUS-G...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.07.019
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The postulated mechanisms of biliary abnormalities in extrahepatic portal venous obstruction (EHPVO) are either extrinsic compression by collaterals or ischemic injury due to venous thrombosis. If the former hypothesis is correct, then biliary changes should revert to normal after portasystemic shunt surgery...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)80013-3
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:EUS-FNA has limitations in cancer diagnosis/staging. New contrast agents, transducers, and processors have improved the potential of contrast-enhanced harmonic (CEH)-EUS. OBJECTIVE:To determine optimal settings and preliminary accuracy of CEH-EUS by using a second-generation perflutren lipid microsphere con...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.09.014
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Recent research suggests that the colonoscopy polyp detection rate (PDR) varies by time of day, possibly because of endoscopist fatigue. Mayo Clinic Rochester (MCR) schedules colonoscopies on 3-hour shifts, which should minimize fatigue. OBJECTIVE:To examine PDR variation with the MCR shift schedule. DESIG...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.07.025
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Bleeding from gastric varices larger than 2 cm in diameter represents a major limitation for endoscopic hemostasis. METHODS:Endoscopic ligation of gastric varices was performed with detachable snares and elastic bands in 41 patients who had recent bleeding from gastric varices larger than 2 cm in diameter. ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.125104
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Monopolar hot biopsy forceps (HBF), bipolar HBF, and cold biopsy forceps (CBF) followed by bipolar electrocoagulation are used clinically to simultaneously perform a biopsy and coagulate diminutive colon polyps and angiomata. Our purpose was to conduct a randomized, controlled study to evaluate the safety of...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70013-7
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Esophageal metastasis of hepatocellular carcinoma (HCC) is extremely rare; it was not serially followed-up by endoscopy. OBJECTIVE:Our purpose was to report the endoscopic findings according to the progression of esophageal metastatic HCC. DESIGN:Case report. RESULTS:In the review of the cases, submucosal...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2008.02.043
更新日期:2008-07-01 00:00:00
abstract::Obstruction of the main pancreatic duct with secondary upstream ductal hypertension is one cause of pain in patients with pancreatic cancer. Pancreatic endoscopic stenting and decompression of the pancreatic duct have been effective in the treatment of pain secondary to chronic calcifying pancreatitis and in one case ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70263-1
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Forming anastomoses between two hollow organs at flexible endoscopy might reduce the need for surgery for obstructing malignancy. Current methods require access to both lumens. The aim of this work was to develop methods of forming an anastomosis at flexible endoscopy, such as a gastrojejunostomy or cholecys...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/s0016-5107(03)02006-6
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Hospitals increasingly need, besides effectiveness data, accurate and reliable cost data to allocate their resources as efficiently as possible. In this article, a framework to calculate the hospital costs of setting up a new activity is presented and applied to pediatric endoscopy. METHODS:The cost calcula...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(96)70007-x
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Complications after endoscopic biliary sphincterotomy occur in 8% to 10% of patients when studied prospectively. It is not known whether the type of electrocautery current affects this rate. Theoretically, less edema of the ampulla after a pure cutting current sphincterotomy could decrease the risk of pancre...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(98)70348-7
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Chronic radiation proctitis (CRP) is a common problem in patients receiving pelvic radiation. Current therapies have the potential for deep tissue injury with ulcerations, perforation, and fistula formation. Cryospray ablation therapy offers superficial ablation of mucosa and is a potential method to endosco...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.10.044
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Endoscopic sphincterotomy is difficult and sometimes impossible in patients who have undergone gastrectomy or partial gastrectomy with Billroth II reconstruction. For such patients, a novel technique was developed in which endoscopic sphincterotomy is performed via percutaneous transhepatic cholangioscopy. T...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)00170-1
更新日期:2004-05-01 00:00:00
abstract::Percutaneous endoscopic gastrostomy (PEG) provides a non-surgical alternative to long-term enteral feeding. The gastrostomy tube, however, may deteriorate, malfunction, or be accidentally expelled, requiring replacement. A commercial gastrostomy tube is commonly used for replacement. However, a commercial replacement ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(94)70165-2
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Colonoscopy is the preferred screening method for colorectal cancer. However, it has a substantial miss rate for colon polyps, and several techniques have been attempted to improve this limitation. Narrow-band imaging (NBI) is a novel technology that enhances the visualization of surface mucosal and vascular...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.07.036
更新日期:2008-02-01 00:00:00